電子學習護照在放射教學之應用

研究目的：醫事放射實習學生的訓練中包含了臨床教育一項，學生必須到醫院進行為期28週的臨床實習方能取得實習證明。取得實習證明方可畢業以及報名專門職業及技術人員高等醫事放射師考試。大學第四年的學生會至醫院進行臨床訓練，期間輪流至各放射機房學習常規攝影檢查、核醫、血管攝影等特殊檢查，以及碎石、放腫等治療型的臨床業務。在本研究中，每年平均收訓12名來自不同學校的實習學生。對於實習學生受訓前後，實習教師準備事項及實習學生須繳交的作業等描述。藉由數位學習的普及進一步將紙本作業發展成電子學習歷程（E-Portfolio）。本研究以北部某醫學中心建置Moodle數位教學平台之經驗，統計近年來本研究之醫事放射實習教師及實習學生多年來的經驗及成效，希望藉由此研究驗證數位化學習系統合併導入翻轉教學達到提高實習學生學習興趣及成效。以及因為紙本作業導致實習教師工作繁重，藉由數位教學平台降低實習教師的工作壓力材料與方法：本文研究對象為北部某醫學中心自104至107年度收訓的醫事放射實習學生，課程內容依據教育部要求的訓練項目而制訂。本研究分別依照各項訓練內容進行課程規劃及教學設計，藉由數位學習平台的普及進一步發展成電子化學習歷程（E-Portfolio）。利用問卷的方式調查研究對象（教師及學生）對於LMS使用前後的滿意度進行分析討論及探討使用E-Portfolio後教學型態的改變與對於教學環境的影響。使用Google表單設計問卷，對學生和老師進行訪問。問卷設計使用李特氏量表分別由1（非常不同意）~5（非常同意）進行評分。IBM SPSS 22.0 分析數據; Ｓtudent t-test 分析臨床教師對於數位學習平台使用前後滿意度是否有顯著差異; Pair-test 分析臨床教師對於數位學習平台使用滿意度相關性;Pearson correlation 評估臨床教師對於數位學習平台使用後滿意度。運用柯式四階層驗證實習學生使用數位學習平台後的學習成效。結果與討論：使用SPSS 22.0分析問卷。sutdent t test分析臨床教師對於數位學習平台使用前後的比較，統計結果顯示在使用前後比較的p值平均為0.0002為顯著差異（p<0.01），表示使用教學平台後不論在教學便利性、教學效率、工作壓力評估等三方面都有明顯的幫助臨床教師。成對樣本相關性的資料中顯示;回饋學生作業便利性(相關性0.559，p:0.003)、師生雙向互動的便利性(相關性0.580，p:0.002)、使用教學平台批改考卷的時間(相關性0.599，p:0.001)，此三項有很顯著的相關性（p<0.01）。表示使用數位學習平台後對於批改學生作業、統計成績以及分析問卷回饋的部份讓臨床教師最有感。討論：經由數據顯示年齡、服務年資、性別、使用手機及電腦的時數對於教學平台的問卷中並沒有顯著的差異;我們可以解釋為放射科中使用的儀器皆為高端儀器，日常工作中與電腦及網路系統息息相關，因此在使用數位學習平台上並不會因為上述問題而有所受限或困擾。另外最為顯著正相關的部分皆在於追蹤學生進度、持續使用平台的意願、願意推薦他人使用、經由系統能快速得知學生資訊(考試成績及滿意度評分)、整理實習歷程時間、降低人力付出、能有多餘時間在臨床卻不失教學品質以及學生學習成效有感提升。由此可知，使用數位學習平台不但縮短了作業流程，減少人力及物力的付出，另一方面實習教師對於實習學生地學習成效有感的提升。此項分析與實習學生成效評估不謀而合。柯式四階層中分析，顯示實習學生藉由數位學習平台能有效提升學習效能。

關鍵字

醫事放射；數位教學平台；電子學習歷程

並列摘要

Purpose: With the popularity of learning management system (LMS), the paper assignments are further developed into an E-Portfolio. This study uses the experience of the Moodle Learning System establishment in a medical center in north Taiwan to evaluate the experiences and effects of the Moodle Learning System on the clinical teachers and interns . It is hoped that this study can validate that the Moodle helps the flip teaching improve the interns’ learning interests and results and reduce the work pressure of the clinical teachers caused by the heavy workload from paper assignments. Methods and Materials: The subjects of this study are medical radiology students who were trained in a medical center in north Taiwan from 2015 to 2018. The course content was designed according to the training program required by the Ministry of Education. This study conducts curriculum planning and instruction design according to various training contents, and further develops an electronic learning portfolio (E-Portfolio) with the popularization of digital learning platforms. Questionnaires were used to investigate the research objects (teachers and students) to analyze the satisfaction of LMS before and after use and to discuss the changes in the teaching style and the impact on the teaching environment after using E-Portfolio. Use the Google Forms Design Questionnaire to access students and teachers. The questionnaires were scored using a Likert Scale of 1 (very disagree) ~ 5 (very agree). IBM SPSS 22.0 was chosen to analyze data. The Student’s t-test was used to analyze whether clinical teachers have significant differences in satisfaction before and after the usage of LMS. The Pair-test was used to analyze the correlation between clinical teachers' satisfaction and the usage of LMS. The Pearson correlation method was used to evaluate the satisfaction of clinical teachers after they use LMS. The Kirkpatrick’s Model was used to verify the learning effectiveness of the internship students using the LMS. Results: The questionnaire was analyzed using SPSS 22.0. The Student’s t-test was used to analyze a before and after comparison of the effects of the usage of the digital learning platform on clinical teachers. The statistical results show that the p<0.001 before and after use., which is a significant difference (**p<0.01), indicating that after using the teaching platform, it is obviously helpful to clinical teachers regardless of teaching convenience, teaching efficiency and work stress assessment. (See Appendix 2, Appendix 3 and Appendix 4 for details). P < 0.05 (significant), **: P < 0.01 (highly significant); ***: P < 0.001 (extremely significant). The correlation data of the paired samples shows that there is a significant correlation (p < 0.01) on the convenience of assignment feedback sending, the convenience of two-way interaction between teachers and students (correlation 0.580, p<0.01), and the time using the teaching platform to correct the test papers (correlation 0.599, p<0.001). It shows that the clinical teachers had a strong feeling that the use of the digital learning platform was helpful in respect of correcting the student's homework and examination papers and giving feedback. . Conclusion: The statistical data from the questionnaires shows the teaching platform makes no significant differences in issues of age, length of service, gender, as well as usage hours of mobile phones and computers. It can be explained that the instruments used in the radiology department are high-end instruments and the daily works have much to do with computers and network systems, so the usage of the digital learning platform would not be limited or hindered by above issues. The most significant positive correlations are seen in tracking student progress, willingness to use the platform, willingness to recommend others, higher speed in learning student information (test scores and satisfaction scores) through the system, the time spent in codifying the internship process, reducing manpower, extra clinic time without losing the quality of teaching and the improvement of students' learning outcomes. From this we know that the use of the digital learning platform not only shortens the work flow, but also reduces the manpower and material requirements. On the other hand, the student teachers see improvement on the learning outcome of the intern students. This analysis coincides with the assessment of the effectiveness of the internship students. The analysis of the effectiveness of the internship students using the four-level hierarchy of the Kirkpatrick Model, which shows that the intern students can effectively improve their learning performance through the digital learning platform.